Active NPI
Carole B. Menard
- General Practice Dentistry
- Anchorage, AK
National Provider Identifier
1184866360
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- AA824
- Practice address
- 3500 Seawolf Dr.
Anchorage, AK 99508-4614 - Phone
- (907) 786-6960
- Fax
- (907) 786-6937
- NPI assigned
- Apr 2, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | AA824 | AK | Primary |
Addresses
Primary practice location
3500 Seawolf Dr.
Anchorage, AK 99508-4614
Mailing address
3211 Providence Dr.
Ahs131
Anchorage, AK 99508-4614
Phone (907) 786-6960
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| AA824 | Other | AK | DENTAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AA824 | AK | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238630400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238630400000",
"number": "1184866360",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3211 PROVIDENCE DR.",
"address_2": "AHS131",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084614",
"telephone_number": "907-786-6960",
"fax_number": "907-786-6937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3500 SEAWOLF DR.",
"city": "ANCHORAGE",
"state": "AK",
"postal_code": "995084614",
"telephone_number": "907-786-6960",
"fax_number": "907-786-6937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MENARD",
"first_name": "CAROLE",
"middle_name": "B.",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-04-02",
"last_updated": "2009-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AK",
"license": "AA824",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DENTAL LICENSE",
"identifier": "AA824",
"state": "AK"
}
],
"endpoints": [],
"other_names": []
}Other providers in Anchorage, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.